Joint replacement is one of the commonest operations performed in the UK It is estimated that 58% of patients following joint replacement will report moderate to severe pain that is poorly controlled. The aim of this audit was to identify pre-operative risk factors that would indicate high levels of post-operative pain. 
All Patients attending joint school where invited to take part by completing a series of self-administered validated questionnaires over a period of 2 months. Additional audit tool was used to collect data regarding peri-operative analgesia, post-operative analgesic prescribing.
40 / 50 questionnaires were completed, In the pre-operative assessment 20 patients reported a pain score >7 / 10, 17 reported neuropathic symptoms on SLANS and 15 were identified as catrastrophisers. 11 patients scored highly in all three risk groups.
Those who had all three risk factors reported pain scores 2 points higher on day 1 post op and one point higher on day of discharge when compared with patients who had no risk factors. They also required significantly higher opioid requirements during their admission (172.5mg vs 99.28mg).
There is a clear link between pre-operative risk factors and increased post-operative pain and opioid consumption. Through identification of at risk patients additional analgesia can be arranged to ensure adequate post-operative pain control.

EVALUATING INCIDENCE AND PREVALENCE OF PAIN IN PATIENTS ATTENDING FOR ELECTIVE JOINT REPLACEMENT